Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
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J Stroke Cerebrovasc Dis · Jan 2010
Randomized Controlled Trial Multicenter StudyReduction in the incidence of poststroke nosocomial pneumonia by using the "turn-mob" program.
One of the most common complications in patients with acute ischemic stroke (AIS) is pneumonia, a complication that has an impact on the patient's survival. The purpose of this study was to establish whether the implementation of a passive turning and mobilization program can prevent the occurrence of nosocomial pneumonia (NP) in patients with AIS. ⋯ The turn-mob program applied on patients during the acute phase of an ischemic stroke decreases the incidence of NP.
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J Stroke Cerebrovasc Dis · Jan 2010
Case Reports Multicenter StudySymptomatic delayed reocclusion after initial successful revascularization in acute ischemic stroke.
Endovascular stroke therapy is used for patients with ischemic stroke after failed intravenous thrombolysis or in patients not eligible for thrombolytics. With increasing experience, acute reocclusion has been described and likely worsens clinical outcomes. We assessed the rates and outcomes of delayed symptomatic reocclusion after endovascular therapy for acute ischemic stroke. ⋯ Delayed symptomatic reocclusion after initial endovascular stroke therapy can lead to sudden clinical deterioration and impact outcomes. The entity may be missed as many patients present with large clinical deficits at presentation thus requiring careful assessments of patients treated via endovascular methods.
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Mild stroke survivors are generally discharged from acute care within a few days of the stroke event, often without rehabilitation follow-up. We aimed to examine the recovery trajectory for male patients and their wife-caregivers during the 12 months postdischarge. ⋯ Despite improvement in patients' functional status, other patient and wife-caregiver psychosocial outcomes during the 12 months postdischarge may be negatively affected. Thus, attention needs to focus on recovery beyond functional outcomes.
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J Stroke Cerebrovasc Dis · Jan 2010
Randomized Controlled Trial Multicenter StudyTime of day, outcome, and response to thrombolytic therapy: the National Institute of Neurological Disorders and Stroke Recombinant Tissue Plasminogen Activator Stroke Trial experience.
Circadian pattern for the onset of acute ischemic stroke has been described; however, data assessing an association between thrombolytic therapy efficacy and circadian rhythm are limited. We assessed the relationship between the time of stroke onset and neurologic outcomes after thrombolytic therapy for acute ischemic stroke in the National Institute of Neurological Disorders and Stroke (NINDS) Recombinant Tissue Plasminogen Activator (rt-PA) Stroke Trial. ⋯ We did not find a circadian pattern to time of day of stroke onset in the patients included in the NINDS rt-PA Stroke Trial. The effect of rt-PA treatment on favorable outcome was independent of time of day of stroke onset. Patients who received rt-PA between 4 and 8 am were less likely to develop symptomatic ICH.
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J Stroke Cerebrovasc Dis · Jan 2010
Randomized Controlled TrialA randomized controlled trial of the effect of fixed-dose routine nocturnal oxygen supplementation on oxygen saturation in patients with acute stroke.
Mild hypoxia is common in patients with stroke, and associated with worse long-term outcome. Oxygen supplementation could prevent hypoxia and improve recovery. A previous study of routine oxygen supplementation showed no benefit after acute stroke, but did not report compliance and the effect on oxygenation. The aim of this study was to assess the effect of routine low-flow oxygen supplementation on oxygen saturation (SpO(2)) in patients with acute stroke. ⋯ Nocturnal oxygen supplementation at a rate of 2 L/min increases the mean nocturnal SpO(2) by 2.5% and reduces the number of nocturnal desaturations in patients with acute stroke.